242 PASSIVE IMMUNIZATION 



infections with the pyogenic cocci, viz., the meningococcus, the 

 streptococcus, the pneumococcus, the gonococcus, and the staphylo- 

 coccus. Of these the antimeningococcus serum is, however, prac- 

 tically the only one with which notable curative results have been 

 obtained. It will accordingly be considered in some detail, while the 

 remainder need not occupy our attention to any great degree. 



MENINGOCOCCUS MENINGITIS 



Attempts to produce an antiserum for the treatment of meningo- 

 coccus meningitis in the human being have notably been made by 

 Flexner and Jobbling, Kolle and Wassermann, and Jochmann, and 

 it may be said that the efforts of all these investigators have been 

 crowned with a great degree of success. From the therapeutic 

 standpoint very little difference indeed appears to exist in the 

 efficacy of the three preparations in question, but there is still a 

 good deal of difference of opinion in regard to their mode of action. 

 All three contain agglutinins, precipitins, complement binding anti- 

 bodies, bacteriolysins, bacteriotropins, and possibly also some anti- 

 toxins. From the different accounts that have been given, the con- 

 clusion suggests itself that while antitoxins may possibly play a role, 

 this is unquestionably of minor importance when compared with 

 the marked inhibitory effect which the serum exercises upon the 

 multiplication of the organisms, and to its manifest bacteriotropic 

 action, as evidenced by increased phagocytosis. 



Flexner thus records that in two children who had received sub- 

 dural injections of his serum, scarcely any extracellular diplococci 

 could be found after the first treatment, while the number of intra- 

 cellular cocci was much reduced, and that cultures could no longer 

 be secured, even though the free forms had not yet disappeared 

 altogether. 



Flexner suggests that the phagocytic digestion not only pre- 

 vents further multiplication of the diplococcus, but also that it 

 detoxicates the endotoxin by reducing it to simpler and non-toxic 

 or less toxic compounds. 



That bacteriolysins per se, however, may also play a role is sug- 

 gested by the observation that in a few instances in which the 

 antiserum was injected into the spinal canal of monkeys infected 



